Provider Demographics
NPI:1740317429
Name:HOLLSTEIN, SARA RUTH (CRNP)
Entity type:Individual
Prefix:MRS
First Name:SARA
Middle Name:RUTH
Last Name:HOLLSTEIN
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:MS
Other - First Name:SARA
Other - Middle Name:RUTH
Other - Last Name:WILTERDINK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSN, CRNP
Mailing Address - Street 1:PO BOX 1111
Mailing Address - Street 2:
Mailing Address - City:HARLEYSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19438-0907
Mailing Address - Country:US
Mailing Address - Phone:215-453-4995
Mailing Address - Fax:215-453-4646
Practice Address - Street 1:700 LAWN AVE
Practice Address - Street 2:
Practice Address - City:SELLERSVILLE
Practice Address - State:PA
Practice Address - Zip Code:18960-1548
Practice Address - Country:US
Practice Address - Phone:215-453-4118
Practice Address - Fax:215-453-4769
Is Sole Proprietor?:No
Enumeration Date:2007-02-28
Last Update Date:2016-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP009225363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health